Experts explained that the U.S. resistance, although extreme, was nothing new. The United States previously demonstrated its allegiance to the formula industry by refusing to sign on to the World Health Organization’s Ban on the Marketing of Breast Milk Alternatives.

This U.S. stance, like its intimidation of Ecuador, flew in the face of near universally accepted medical and scientific research proving that breastfeeding saves lives. Perhaps even more surprisingly, both acts perpetuate an alarming racial divide in breastfeeding rates that leads to significant racial health disparities. American support of the formula industry comes at the cost of the health and lives of Black and brown babies, at home and abroad.

Both the resolution and the U.S. opposition to it stemmed from a decline in formula sales in the United States. The industry has sought to make up for its considerable domestic losses on the global market. The racial aspects of this local-global dynamic are hidden in plain sight.

The relatively large number of American women who die due to childbirth is one of the little-known facts in our country. In a nation where we spend exorbitant amounts on healthcare, we have the highest maternal mortality rate of any other developed country. Word, however, is getting out that women are increasingly susceptible of dying during childbirth with a surge in articles in major publications and of hospitals, healthcare workers, and researchers working together to solve this problem.

After eight years of practicing obstetrics and researching childbirth in the United States, I know as well as anyone that the American maternal health system could be better. Our way of childbirth is the costliest in the world. Our health outcomes, from mortality rates to birth weights, are far, far from the best.

The reasons we fall short are not obvious. In medicine, providing more care is often mistaken for providing better care. In childbirth the relationship between more and better is complicated. Texan obstetricians, when compared to their counterparts in neighboring New Mexico, are 50% more likely to intervene on the baby’s behalf by performing a cesarean section. Nonetheless, Texas babies still have a lower survival rate than New Mexican babies.

I long assumed that our most puzzling American health care failures were idiosyncrasies–unique consequences of American culture, geography, and politics. But a trip to India for the 2017 Human Rights in Childbirth meeting led me to a humbling realization: when it comes to childbirth, both countries fall short in surprisingly similar ways.

Neel Shah, center, pictured with Jishnu Das, a Lead Economist at the World Bank and Leslie Page, President of the Royal College of Midwives. Neel Shah, Author provided

Human rights in childbirth

I take care of patients in at a well-funded teaching hospital in Boston, where pregnant women seem well-respected and have clear, inviolable rights.

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Our Global Health Reporting

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